Current Versions: 2.1
Last Updated: 8/31/2009 1:39 AM
Author: Keith Gabryelski
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Questions about health care reform
Presented are Health Care questions from members of the blog Little Green Footballs (http://littlegreenfootballs.com) collected by Keith Gabryelski (email@example.com). Some of the questions were pulled from other sites by LGF members. Attributions have not been kept, but can be found here (http://littlegreenfootballs.com/article/34424_What_Would_You_Ask_About_Health_Care).
I have re-worded sentences to ask a specific question, remove spelling and grammatical errors, tighten up and to clarify, and to remove offensive tone.
The current document (as well as archives) can be found at: http://www.gabryelski.com/hcr-questions
The goal of this document is to maintain a list of questions that the President and Congress should answer before voting on any health-care bill.
Answers to questions are also logged so that we can ensure the questions were answered completely, for posterity (read truth), ensuring we don’t ask the same question twice (wasting a questioner’s opportunity to engage their lawmaker), and track answers who may offer more or deeper questions.
You can help by asking questions and recording answers. Please send your new questions and answers to questions to firstname.lastname@example.org. Answers should contain reference information (how the answer was derived, who answered the question, when, where, and a link to the recording if possible).
If you think a question is misclassified, by all means, should be asked in a slightly different way or needs clarification, please speak up.
If you think a question hasn’t been answered fully, please point out where the holes are.
First level bullet points are questions. Second level bullet points are probable duplicates (placed under the bullet item they duplicate). Second level bullet points are slated from removal in a future document revision.
Question 1.1: What is the name of the bill?
Answer 1.1: American Affordable Health Choices Act of 2009 (H.R 3200)
Status 1.1: ANSWERED
Question 1.2: Where can the text of this bill be found online?
Status 1.2: PARTIALLY – expected to change
Question 1.3: Will the text of the bill be complete and not subject to further change before you vote on it?
Status 1.3: UNANSWERED
Question 1.4: Has everyone that will vote on this bill read it, understand it, and understand its benefits and consequences?
Status 1.4: UNANSWERED
Question 1.5: What is the closest currently working system that is like the one you are proposing that we can examine for its cost/benefits
Status 1.5: UNANSWERED
Question 2.1: Who is doing the actuarial work and determining standards of coverage?
Status 2.1: UNANSWERED
Question 2.2: How will it compare to private plans being offered now?
Status 2.2: UNANSWERED
Question 2.3: Are Illegal immigrants covered under the plan? What is the additional cost?
Answer 2.3: H.R. 3200: Sec 246 — NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS (Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.)
Reference 2.3: http://www.factcheck.org/2009/08/seven-falsehoods-about-health-care/
Status 2.3: ANSWERED (but has follow-ups 2.4)
Question 2.4: The bill provides that there will be "NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS." How would an undocumented alien be distinguished from citizens when requesting health care (or more specifically, when the hospital gets reimbursed)?
Status 2.4: UNANSWERED
Question 2.5: Will religious organization hospitals qualify under the plan if they refuse to perform abortions?
Status 2.5: UNANSWERED
Question 2.6: Will there be parity for patients with Mental Illness?
Status 2.6: UNANSWERED
Question 2.7: How will this plan ensure patients with serious mental illness have access to psychiatrists?
Status 2.7: UNANSWERED
Question 2.8: How will Mental Illness be defined?
Status 2.8: UNANSWERED
Question 2.9: Does drug treatment or alcohol treatment, fall under the rubric of Mental Illness and if so, why?
Status 2.9: UNANSWERED
Question 2.10: Will the insurance cover experimental and new treatments?
Status 2.10: UNANSWERED
Question 2.11: Does this coverage include long term care/ assisted living facility/SNF? If so, for how long and in exchange for what? Will all property and other assets be seized?
Status 2.11: UNANSWERED
Question 2.12: Will abortion be classified as simple surgery by the bill or will it remain under its own classification?
Status 2.12: UNANSWERED
Question 2.13: Can you guarantee No person will be refused medical care because the cost to value equation is deemed not good enough to provide treatment?
Status 2.13: UNANSWERED
Question 2.14: Will we get the same coverage at the same price as all of the senators and congress members have.
Status 2.14: UNANSWERED
Question 2.15: Are there caps per year, per lifetime?
Status 2.15: UNANSWERED
Question 2.16: Are there limits - can anyone be covered or just people below a certain income?
Status 2.16: UNANSWERED
Question 2.17: Will the government end up paying for people's marijuana in those states with medical marijuana laws? And if not, on what basis can the government disallow valid prescriptions?
Status 2.17: UNANSWERED
Question 2.18: Proponents of the different health care reform bills maintain that it is a myth and disinformation to assert that "Illegal aliens will be covered under health care reform". As a resident of San Diego County, I know that it is common for illegal aliens to show up in emergency rooms and that they get treated with the cost often passed to county government, or passed to all other users of the medical system in the form of higher costs. It would be unethical for these people to go untreated for acute needs - even mothers giving birth to so-called "anchor babies" need to be treated as do their infants. Few Americans would advocate letting illegal aliens die in the streets. So, how is it that such treatment would be extended without burdening American taxpayers either directly or through higher costs? Is there a "bright line" that you can articulate where compassionate care end, and will there be a mechanism for billing the governments of these people for the care extended to their citizens?
Status 2.18: UNANSWERED
Question 3.1: How much will it cost per year for the first 40 years.
Status 3.1: UNANSWERED
Question 3.2: The health care plan is estimated to cost $1 trillion in the first ten years. Many of the expensive provisions don't take effect right away, lowering the ten-year cost. What will the health care plan cost in its second ten-year span?
Status 3.2: UNANSWERED
Question 3.3: How much will this realistically cost, given that every other government program has gone staggeringly over cost projections.
Status 3.3: UNANSWERED
Question 3.4: Is there a penalty for people opting not to obtain health insurance, and what is the thinking behind limiting personal choice in that fashion? After all, if that person doesn't want to pay for the health insurance, and is penalized, that's a back-door tax.
Status 3.4: UNANSWERED
Question 3.5: Can you tell us the amount of the new taxes and who will be paying them?
Status 3.5: UNANSWERED
Question 3.6: Will the Federal Government to go into our bank accounts and automatically electronically to deduct premium payments without authorization.
Status 3.6: UNANSWERED
Question 3.7: Will there be jail time for those who refuse to pay for health insurance if they have none from their job? ... if they have no money for the government to confiscate?
Status 3.7: UNANSWERED
Question 3.8: How will this be paid for each year for the first 40 years?
Duplicate: 3.8.1: Like others I would ask how we are going to pay for this not only currently, but going forward in 20, 30, 40 years.
Duplicate: 3.8.2: How is the plan underwritten?
Status 3.8: UNANSWERED
Question 3.9: Show me on paper, with real CBO approved numbers, how you will pay for this.
Status 3.9: UNANSWERED
Question 3.10: How is it that you can put together a health care bill without knowing how to pay for it? As admitted by Members of Congress (Ben Cardin), no one knows how this will all be paid for. Wouldn't it make more sense to know first where the money comes from and design a system than try and throw everything and the kitchen sink and realize later you have to raise taxes?
Status 3.10: UNANSWERED
Question 3.11: Where are you drawing the line on the income level of those who will see an increase in their taxes as a result of this plan?
Status 3.11: UNANSWERED
Question 3.12: How can this plan be revenue neutral if you are creating an entirely new government bureaucracy and subsidizing the cost for millions of people?
Status 3.12: UNANSWERED
Question 3.13: Medicare cuts costs by paying lower rates to doctors and hospitals, which then shift these costs to those of us with private health insurance, which get charged higher rates. But if the government takes over and starts dictating Medicare reimbursement rates for everyone, who will the costs get shifted to then?
Status 3.13: UNANSWERED
Question 3.14: Can you guarantee Health care funding will be second on the budget priority only to the defense of the country?
Status 3.14: UNANSWERED
Question 3.15: How can you reconcile loading another trillion dollars onto our debt and commit to “I won't sign a bill that will add to the national debt"?
Status 3.15: UNANSWERED
Question 4.1: Will the public option be part of the final bill?
Status 4.1: UNANSWERED
Question 4.2: Can you ensure that if I lose my current coverage I am not forced, by lack of other options, to accept the 'public option’?
Status 4.2: UNANSWERED
Question 4.3: How long will I have under my existing program until the government health care forces me into the public plan?
Status 4.3: UNANSWERED
Question 4.4: How will the public option not lead to a single payer system?
Status 4.4: UNANSWERED
Question 4.5: How will the public option avoid becoming the ruin that is the VA system, the Medicare system... or anything else the government happens to run?
Status 4.5: UNANSWERED
Question 4.6: In the UK and Canada mortality rates are higher, waits for simple procedures (MRI's) are much longer and innovations in the medical field are generally stunted. How can we be sure this will not be the case with the public option?
Status 4.6: UNANSWERED
Question 4.7: Given that the "public option" would be available nationwide and that the "public option" is supposed to compete with existing carriers on an equal basis, are interstate insurance restrictions going to be eliminated?
Status 4.7: UNANSWERED
Question 4.8: Given that the "public option" is to be self-funded (like most workers' comp. state funds), what statutory restrictions will ensure that (a) the "public option" will not require taxpayer subsidization and (b) that, if the "public option" is as successful as some "state funds" (for workers' comp. ins.), the federal government will not be able to tap into the "public option's" reserves?
Status 4.8: UNANSWERED
Question 4.9: Wouldn't the "public option" alone be a great and significant step toward expanding the range of coverage, increasing competition, and improving outcomes? That is, given that the "public option" is to be self-funded and achieve such great efficiencies and pick low-hanging fruit (that is claimed to exist by proponents of health care "reform"), wouldn't it be a major victory to simply establish the "public option" and prove to a skeptical public that government can not only run a health care organization but can improve it (and at no taxpayer cost, to boot)?
Status 4.9: UNANSWERED
Question 4.10: Will an entirely self-funded "public option" be viable without mandates requiring one to have health care insurance?
Status 4.10: UNANSWERED
Question 4.11: President Obama cited the Postal Service as an example of a “public option” that struggles alongside private competitors. Can the proponents of co-ops cite examples of successful co-ops that exist alongside private competitors?
Answer 4.11: UNANSWERED
Question 4.12: Over the years, in other areas like farming and consumer goods, some co-ops have succeeded, but many have failed. Doesn’t that make co-ops a risky bet for the chronically poor and uninsured? What happens to their health care if they go with a co-op that goes bust within a few years?
Answer 4.12: UNANSWERED
Question 4.13: There are a couple of not-for-profit medical co-ops in America already. But they stay solvent by denying coverage to folks with pre-existing conditions; and denying coverage to poor folks unable to pay. Doesn’t that suggest that if all insurers are required to take poor folks and folks with pre-existing conditions, that co-ops will have difficulty staying solvent?
Answer 4.13: UNANSWERED
Question 4.14: Blue Cross used to be a not-for-profit co-op till the 1980s, when some of them converted into a bunch of for-profit companies. Will any of the co-ops planned for health care reform also be allowed to convert to for-profit companies in the future?
Answer 4.14: UNANSWERED
Question 4.15: Proponents of health care reform have attacked some private plans as overly generous—so-called “Cadillac” plans. (And they want those “Cadillac” plans taxed.) How much less coverage will the public option offer as compared to typical “Cadillac” plans?
Answer 4.15: UNANSWERED
Question 5.1: How much choice will I be allowed to have in selecting my doctor?
Status 5.1: UNANSWERED
Status 5.2: UNANSWERED
Question 5.3: How much choice will my doctor and I have for any treatments/care I might need?
Status 5.3: UNANSWERED
Question 5.4: What parts are mandatory for doctors?
Status 5.4: UNANSWERED
Question 5.5: What are the consequences for a doctor who doesn't take patients under the plan?
Status 5.5: UNANSWERED
Question 5.6: What parts are mandatory for patients?
Status 5.6: UNANSWERED
Question 5.7: Can you opt out of any insurance?
Status 5.7: UNANSWERED
Question 5.8: Can you have non-plan surgeries?
Status 5.8: UNANSWERED
Question 5.9: In the advanced care section can you refuse the counseling, and if you do what are the consequences?
Status 5.9: UNANSWERED
Status 5.10: UNANSWERED
Question 5.11: Can you volunteer a Kidney and still be covered?
Status 5.11: UNANSWERED
Question 5.12: If my employer opts to switch from a plan I like to the subsidized public plan due to lower premiums, how do you suggest that I keep the plan that I like.
Status 5.12: UNANSWERED
Question 5.13: What happens to one's ability to purchase private insurance/join another private plan once a person switches employers/moves to another job?
Status 5.13: UNANSWERED
Question 5.14: If my current plan does not meet the government's definition of a "qualifying plan" will I have to pay a tax to the treasury every year?
Status 5.14: UNANSWERED
Question 5.15: Why am I supposed to give up my current health care plan when my elected officials are not required to give up their plan?
Status 5.15: UNANSWERED
Question 5.16: If I choose to purchase only catastrophic care/major medical insurance and pay routine expenses out-of-pocket, will I be able to do so?
Status 5.16: UNANSWERED
Question 5.17: The health-care bill will mandate what costs insurance companies have to cover. For example, they will have to pay for routine check-ups and physicals, or they will have to provide every woman with maternity coverage. But what if you don't want to pay for that extra coverage? Right now, if you're young and healthy and don't need frequent check-ups, you can save money with a high-deductible insurance that doesn't cover them. Or if you don't want children, or already have children, you can save money by dropping the maternity rider on your policy. By taking those choices away from us, won't this bill actually make our insurance more expensive, not less?
Status 5.17: UNANSWERED
Question 6.1: What negative side effects have you/your advisers calculated may occur because of these new laws/programs put into place. If you haven’t foreseen any problems, how can we trust you have vetted this reform carefully enough? Do you believe we can understand/anticipate most significant unintended consequences?
Status 6.1: UNANSWERED
Question 6.2: What is in the bill currently to prevent and manage unintended consequences?
Status 6.2: UNANSWERED
Question 6.3: Can you guarantee that this system will not be run like the VA system?
Status 6.3: UNANSWERED
Question 6.4: With the passage of any such bill, the federal government would then have a vested interest in reducing health care costs via reducing services, or the need for services. Would this result in the regulation of what foods an individual is permitted to eat, or the amount of any given food for that matter? Will the amount of exercise, hygiene, and/or good housekeeping be regulated to ensure that individuals covered are prevented, by law, from engaging in getting sick and/or hurt?
Status 6.4: UNANSWERED
Question 6.5: Is this bill leading to a single payer healthcare plan considered a consequence?
Status 6.5: UNANSWERED
Question 6.6: When we were freelance workers, my wife and I were both refused any insurance of any kind because of pre-existing conditions. Even thought we were both doing fine financially and were well, we couldn't get insurance, and so I took a full-time job in a large company just to get insurance. Will this new system allow more people to leave large companies, and will that have an effect on how employment will be structured in the US?
Status 6.6: UNANSWERED
Question 7.1: How many new government employees are needed to oversee this?
Status 7.1: UNANSWERED
Question 7.2: Will this be mandatory or can the law be made to make sure it never is.
Status 7.2: UNANSWERED
Question 7.3: How much paperwork will be involved?
Status 7.3: UNANSWERED
Question 8.1: How can you convince those worried about end of life counseling and euthanasia that there is nothing in the bill that's sinister?
Status 8.1: UNANSWERED
Question 8.2: Do you intend to implement a program such as NICE and QALY in the UK that approves or denies treatment based on statistical outcomes of a population, rather than what a medical professional believes is the best course for an individual patient?
Status 8.2: UNANSWERED
Duplicate: 8.2.1: Do you know the meaning and significance of the term "quality adjusted life year"? (For this question, you will need the answer, which you can supply if your congressman is forced to admit that he doesn't know it—preferable after some stammering and a long, awkward pause. "Quality adjusted life year" is a term used under socialized medicine to determine whether elderly patients are allowed to get expensive drugs or treatments, depending on some bureaucrat's calculation of how many good years they have left. You should ask your congressman: Can you assure us that the same thing won't happen here?)
Question 8.3: Will you sign a plan that in any way incorporates Quality-Adjusted Life Years determinations or uses comparative effectiveness determinations that treat the population as a whole instead of patients as individuals?
Status 8.3: UNANSWERED
Question 8.4: I have heard repeatedly that there will be no "rationing” of care. What do you think will happen to the existing system when 45 million more people are added?
Status 8.4: UNANSWERED
Question 8.5: One of the proposals for how the government is going to save money is that it's going to have a panel of medical experts who will dictate from Washington, DC, what the proper medical practices are that should be paid for, and what practices are supposedly "wasteful" and "unnecessary." Won't this mean interfering with decisions that would normally be made by me and my doctor? And won't this discourage innovation by requiring any new idea to get approved by a board of establishment "experts" before a doctor can even try it out?
Status 8.5: UNANSWERED
Question 9.1: How will this plan encourage continued medical R&D?
Status 9.1: UNANSWERED
Question 9.2: How will this plan encourage people to pursue careers in medicine?
Status 9.2: UNANSWERED
Question 9.3: Will this help (or harm) addressing our current shortage of doctors?
Status 9.3: UNANSWERED
Question 9.4: How does that shortage (of doctors, if there are) affect implementation of your plan?
Status 9.4: UNANSWERED
Question 9.5: How will you address any problems that arise because of that (doctors) shortage?
Status 9.5: UNANSWERED
Question 9.6: What will be the effects on rural health care and small clinics?
Status 9.6: UNANSWERED
Question 9.7: In order to implement your plan & not add to the deficit as you claim, you will have to adjust physician fee schedules. It may be capitation or a hybrid of Diagnostic Review Groupings or another formula. In any case doctor incomes will have to be drastically reduced. How do you intend to entice bright young people to enter Med School when even now there is a shortage?
Status 9.7: UNANSWERED
Question 9.8: One of the ways that has been proposed for government-provided health insurance to save money is by substituting Medicare reimbursement rates for market rates when paying doctors and hospitals. But many private hospitals and medical practices have said that if they have to accept these lower rates, they can't cover their expenses, and they will go out of business. So doesn't this bill guarantee an immediate shortage of doctors and medical services?
Status 9.8: UNANSWERED
Question 9.9: When the government starting portraying people in the financial industry as villains and started limiting their pay and subjecting them to more regulations, banks reported a "brain drain" as smart and well-educated people left the industry or went overseas looking for better pay and less stress. But the term "brain drain" was originally coined in the 1960s when doctors and medical researchers left Britain to escape socialized medicine. Aren't you afraid we might see the same kind of brain drain from the medical profession here in America?
Status 9.9: UNANSWERED
Question 10.1: How does this affect military health care?
Status 10.1: UNANSWERED
Question 10.2: What are the impacts and changes to Social Security and SSI?
Status 10.2: UNANSWERED
Question 10.3: What are the changes to Medicare?
Status 10.3: UNANSWERED
Question 10.4: Will you say "no" to the Trial Lawyers Association and include genuine tort reform in this or any other bill?
Status 10.4: UNANSWERED
Question 11.1: Will this require new regulations or restrictions that limit the current boom in boutique and flat fee clinics?
Status 11.1: UNANSWERED
Question 11.2: President Obama keeps telling us that he's not trying to get rid of private health insurance. But the bill being debated in Congress would require all new insurance policies to be offered through a government-run exchange, in which the rates that can be charged and the coverage that has to be provided will be dictated by the government's so-called "Health Choices Commissioner." Employer-provided health-insurance will fall under the same regulations in five years. How is this insurance going to be "private" if the government controls everything about it?
Status 11.2: UNANSWERED
Question 11.3: The health-care bill that is being discussed includes huge taxes on businesses to force them to provide more health insurance for their employees, as well as a whole set of mandates telling health insurance companies who they have to cover and what they have to cover them for. This is an enormous increase of costs for businesses and insurers. Have you considered how they're going to pay for all of this, or whether they will even be able to pay for it? How many of these companies will go out of business or lay off more workers after the government forcibly increases their expenses?
Status 11.3: UNANSWERED
Question 11.4: What is the estimated rise in unemployment, and will unemployment benefits be extended to cover those who lost their jobs because their employer couldn't afford this mandate?
Status 11.4: UNANSWERED
Question 11.5: Will there be corporate welfare to help companies pay for this mandate?
Status 11.5: UNANSWERED
Question 11.6: Will you provide relief to former insurance company employees who lose their jobs when their companies are unable to compete with the public option?
Status 11.6: UNANSWERED
Question 11.7: Has anyone estimated the cost consequences of companies simply paying the fines and dropping coverage for employees all together thereby having more people enroll in the government plan?
Status 11.7: UNANSWERED
Question 12.1: Government programs have often managed to long outlive their usefulness, or to keep going in the case of obvious failure. Would you be willing to build in a failure condition to the health care plan, in which case the plan would be canceled? What would that failure condition be?
Status 12.1: UNANSWERED
Question 12.2: What feedback-loops are in place to ensure changes are made if these programs are not deficit neutral or serious unknown side effects are seen?
Status 12.2: UNANSWERED
Question 12.3: Before passing the bill, will you create a line item by line item assessment of what each problem a line item solves and what concerns it brings? Will you review these assessments yearly after the law passes?
Status 12.3: UNANSWERED
Question 12.4: What is or isn't in this one particular bill is not the end of the story. For example, how many times has Medicare changed over the last forty years? As more and more of us become dependent on the government for our health-care coverage, won't we have to worry about what some future Congress or some future bureaucrat will decide to cover or not cover?
Status 12.4: UNANSWERED
Question 13.1: Would you commit yourself and your family to use the same health care system as you want to put in place for the rest of us?
Duplicate: 13.1.1: Will you endorse the plan by putting your family on the plan?
Status 13.1: UNANSWERED
Question 13.2: Why won’t our lawmakers automatically be moved to the public option?
Status 13.2: UNANSWERED
Question 13.3: Poor and middle class Americans share a larger burden when we increase the national debt/Federal deficit. Are there consequences you can put into this bill that will directly affect you and those that vote for it should this reform have unintended consequences?
Status 13.3: UNANSWERED
Question 14.1: Why does our health care system need to be changed? Please be specific with facts and information that can be verified and so the American people can apply a value judgment to whether change is needed in this area.
Duplicate: 14.1.1: In plain English -- tell me why I should want this legislation.
Status 14.1: UNANSWERED
Question 14.2: Because I do think something ought to happen, wouldn't it be prudent to list out the real problems with the current system and do a complete root cause analysis on them? Once we determine that, we could offer up solutions that may or may not be in the form of new regulation.
Duplicate: 14.2.1: What is the goal of this anyway? If we clearly understood the goal, perhaps that is a better, more cost efficient way to get there.
Status 14.2: UNANSWERED
Question 14.3: Please give your top three reasons for why this needs to be done instantaneously.
Status 14.3: UNANSWERED
Question 14.4: Why not, instead, address the uninsured population with generous stop loss provisions, so that their true out of pocket exposure would be on a par with the insured population?"
Status 14.4: UNANSWERED
Question 14.5: Why have you sacrificed clarity for speed?
Status 14.5: UNANSWERED
Question 14.6: If we can save money by reducing fraud in our troubled Medicaid and Medicare, why not get started without this cumbersome bill?
Status 14.6: UNANSWERED
Question 14.7: Why does the Federal government need to be involved in healthcare in the first place? Wouldn't it make more sense for each state in the union to create its own healthcare legislation, thereby giving US citizens the right to vote with their feet?
Status 14.7: UNANSWERED
Question 14.8: The government has been "reforming" health-care for sixty years—tax breaks for employer-provided health-insurance, Medicare, Medicaid, encouraging HMOs and managed care, and government health-insurance at the state level in Massachusetts, Maine, and Oregon. Government health-care has expanded until it is now more than 50% of all health-care spending. Yet after sixty years of government "reform," the problems with health-care are just getting worse. So, why should we believe that even more government is the solution?
Status 14.8: UNANSWERED
Question 14.9: Medicare is broke. Social Security is broke. Federal tax receipts are falling, and Congress has already voted on trillions of dollars of stimulus and bailouts in the last year. The national credit card is maxed out. So, how can you justify voting for a bill that will require even more money that we don't have?
Status 14.9: UNANSWERED
Question 14.10: One of the main demands of the health-care bill is that insurers are required to cover people with "pre-existing conditions." That's like getting insurance on your car after you crash it. Doesn’t that mean that the rest of us will have to pay more for our insurance to absorb the cost of people who don’t get healthcare until they have a serious problem?
Status 14.10: UNANSWERED
Question 14.11: Government-run health-care is not some new, untested idea. In Britain, it has led to a "postcode lottery," where the medical procedures you are allow to get depend on where you live. In Canada, it has led to a shortage of doctors and waiting lists for major surgeries. In America, Medicare ended up costing far, far more than anyone expected. Massachusetts and Maine spent enormous amounts of money to extend government coverage to very few people. The Oregon Health Plan may not cover your cancer treatment—but it will cover assisted suicide. Given all of this experience, what makes you think that somehow this will be the exception that will avoid all of the problems that government health-care has always led to?
Status 14.11: UNANSWERED
Question 14.12: Why is there no tort reform in this bill?
Duplicate: 14.12.1: A lot of doctors say that medical malpractice insurance is what is really driving up health-care costs. Doctors have to charge more to cover their expenses, and they also have to practice "defensive medicine," ordering unnecessary extra tests just to make sure they can defend themselves in court if something goes wrong. So why isn't tort reform—for example, limiting excessive jury awards in malpractice lawsuits—being considered as part of health-care reform?
Status 14.12: UNANSWERED
Question 14.13: Isn't this broad, sweeping reform throwing the baby out with the bathwater? Wouldn't it be much less disruptive and expensive to isolate areas that are insufficient, ineffective or other, and go from there?
Status 14.13: UNANSWERED
Question 14.14: Why not phase in the plan, starting with prenatal to age 12 and from 65 years of age and up? Those groups expend a disproportionate amount of healthcare dollars. (This way, if there are any problems, they can be addressed on a more manageable scale.)
Status 14.14: UNANSWERED
Question 14.15: Why does all this reform need to be considered so expeditiously and all at once? Why can't we do a bill around portability, pre-existing conditions, electronic medical records, allowing small businesses to pool shop for coverage and the other areas where there is some real bipartisan support?
Status 14.15: UNANSWERED
Question 14.16: What if we bought health insurance like we buy car insurance? If our premiums went up because of other people's accidents, we would have a cow about this. If our insurance goes up or is dropped because of 18 DWIs, well, that is our fault, now isn't it?
Status 14.16: UNANSWERED
Question 14.17: Can you give a clear justification for why our health care plans should be tied to (and limited by) the choices our employer or the government want to supply? Will you commit to changing this limitation?
Status 14.17: UNANSWERED
Question 14.18: Can you give a clear justification for laws that disallow insurance companies from offering plans to customers in other states? Will you commit to changing this limitation?
Status 14.18: UNANSWERED
Question 14.19: Since the stated goal of healthcare reform is to ensure those who do not have private insurance, wouldn't it be simpler and less costly for the government to simply pay the private premiums for those who are not currently covered? That cost would be somewhere under $50 billion compared with the trillions anticipated for this currently proposed program, representing a 95% savings over the proposed program.
Status 14.19: UNANSWERED
Question 15.1: Do you believe that you, personally, know what form of health care arrangements is best for me?
Status 15.1: UNANSWERED
Question 15.2: If the impetus for this is total reform because we are faced with impending doom, why do you say I can keep the health care plan I have right now if that is my choice?
Status 15.2: UNANSWERED
Question 15.3: As recently as 2005 I believe you endorsed the single payer model. What has caused you to now reject that?
Duplicate: 15.3.1: A video on YouTube shows Barack Obama back in 2003—only six years ago—saying that he is in favor of a "single payer" system. The "single payer" is government, so this means he was in favor of socialized medicine. And just a few weeks ago, Barney Frank—one of the Democratic leaders in the House—said that he considers the current bill a step toward "single payer." So when Obama and the Democrats tell us this bill won't lead to a government takeover of health-care, why should we believe them?
Status 15.3: UNANSWERED
Question 16.1: Who is actually in charge of writing the bill and if there are outside parties involved ... who are the outside parties contributing to the construction of the bill ...
Status 16.1: UNANSWERED
Question 16.2: Will you work with Congress to ensure bipartisan debate on the final bill?
Status 16.2: UNANSWERED
Question 16.3: You often talk about bi-partisanship. Why then were Republicans frozen out of drafting these proposals? Why was it just Democrats behind closed doors?
Status 16.3: UNANSWERED
Question 16.4: Why are pharmaceutical companies making deals on this with you? Why didn't most of congress know about that?
Status 16.4: UNANSWERED
Question 16.5: What process will be used to reconcile the house and senate versions of the bill? What restrictions (if any) will be placed on earmarks in the bill? What (if any) assurances are there that items which have explicitly been voted down (such as rejected amendments) will not be adding back into the final legislation?
Status 16.5: UNANSWERED
Question 16.6: Will the President promise to subject this bill to the 5 day sunshine and commentary period after reconciliation is complete but before signing it?
Status 16.6: UNANSWERED
Question 16.7: What if any provisions are the President prepared to veto this bill for?
Status 16.7: UNANSWERED
Question 17.1: Somebody, I believe on reason.org, noted that the more government gets involved in medical care, the more the issue becomes politicized. Do you have suggestions for ensuring a long-term barrier between political decisions (in abortion, alternative healthcare, creationism etc) and medical practice?
Status 17.1: UNANSWERED
Question 17.2: Will those whose religious beliefs prohibit them from purchasing health insurance be able to opt out without penalty? (There are some ultra-conservative Christians who believe that insurance represents a form of gambling and is therefore immoral.)
Status 17.2: UNANSWERED
Question 18.1: The president has stated that "UPS and FedEx are doing fine. It's the Post Office that is always having problems". How is that a ringing endorsement of government involvement with regard to healthcare?
Status 18.1: UNANSWERED
Question 18.2: One of the things I noticed when we were uninsured was that all medical procedure costs were much higher than expected. I noticed when I got insurance that the insurance company refused to pay these high prices, and the medical companies would settle for the lower amount offered by the insurer. It felt like the medical companies were gaming the system, and placing the burden on uninsured because they were easier to extract large amounts from than insurers. How can we be sure that either insurers or medical companies won't game the public system in the same way?
Status 18.2: UNANSWERED
Question 18.3: The defenders of the health-care bill claim that it's going to lead to all sorts of savings, not by actually cutting any services or denying care, but just by finding "inefficiencies" that will save money. Do you think this is remotely plausible? When has anybody ever said, "This project has to be lean and efficient—let's get the government do it"?
Status 18.3: UNANSWERED
Question 18.4: Why does "reform" always mean more government? Are you aware of proposals that have been put forward for free-market reforms of health care? Congress has already approved Health Savings Accounts, where individuals buy their own high-deductible health insurance and save money tax-free, which they can use for their out-of-pocket health-care expenses. This gives people more control over their spending on routine medical treatments while keeping them covered for a serious illness, and it allows them to keep their health insurance if they change jobs. But this program has been limited in size. Are you open to ideas like this, for free-market reform of health-care? Why aren’t these proposals a part of this reform bill?
Status 18.4: UNANSWERED
Question 18.5: Why should we believe public health care will improve quality when we've got examples from other countries where care becomes far more restrictive and quality of care is substandard in US government health care programs like the Indian Health Service and the VA.?
Status 18.5: UNANSWERED
Question 18.6: With respect for “Cash for clunkers” and “TARP”. Why should we be confident in how government manages large projects when we see smaller projects mismanaged or misunderstood? In particular, no one understood how many vehicles were in the pipeline for rebates or where the balance stood. The same can apply to the billions utilized under TARP. How can you manage costs when the government can't even keep track of the money on its books?
Status 18.6: UNANSWERED
Question 18.7: If the government mishandles my case or commits some form of malpractice, or denies a procedure, can I sue for damages?
Reference 18.7: Summary of issues: http://rebootcongress.blogspot.com/2009/07/carnahan-healthcare-forum-report-5_25.html
Status 18.7: UNANSWERED
Question 19.1: Could you clarify the portion of the house bill that directs money to "underrepresented minorities" for targeted funding?
Status 19.1: UNANSWERED
Question 19.2: Will your health care plan force care providers to clearly explain the price of their procedures beforehand, like those in every other industry must do?
Status 19.2: UNANSWERED
Question 19.3: Where in this legislation can I find mechanisms to detect and stem fraud and abuse?
Status 19.3: UNANSWERED
Question 19.4: Why does the plan start after you leave office?
Status 19.4: UNANSWERED
Question 19.5: Why are businesses mandated to cover 60-72% of their employees’ premiums or be fined by the government?
Status 19.5: UNANSWERED
Question 19.6: Will we get the same retirement plan at what congress pays for?
Status 19.6: UNANSWERED
Question 19.7: Will insurance companies be required to treat, and price, individual plans the same way they would if that individual was covered by a corporate plan, and will the IRS allow the premiums to be tax deductible in the same way?
Status 19.7: UNANSWERED
Question 20.1: These are all slated for removal since they are not related to health care reform. Please suggest how these should be rephrased or folded into another question.
Status 20.1: UNANSWERED
Question 20.2: We have seen that, in 2003, you supported and expressed your intent to achieve, a single-payer system. Who is the single-payer you had in mind?
Status 20.2: UNANSWERED
Question 20.3: Why do you want to send government agents to speak to parents, especially low income parents and what standard will be used in their education the well trained agents would use as basis for the teaching?
Status 20.3: UNANSWERED
Question 20.4: How do you think Americans feel about the new government plan when told they're un-American?
Status 20.4: UNANSWERED
Question 20.5: How many generations thinking that the government is the alternative to personal responsibility do you expect to create by providing this health care reform? Do you think it will be more than FDR convinced were incapable of self-reliance with the New Deal?
Status 20.5: UNANSWERED
Question 20.6: Can you explain your contempt for those who disagree with you at the public forums and expand as to why they deserve to be singled out?
Status 20.6: UNANSWERED
Question 20.7: If your life depended on it, would you order for overnight delivery a life saving drug with the U.S. postal service, or Fed-Ex, or UPS?
Status 20.7: UNANSWERED
Question 20.8: When will you speak out publicly about the violent behavior of the SEIU Union for attacking a man who was peacefully handing out flags as a form of protest to your plan?
Status 20.8: UNANSWERED
Question 20.9: What does government intervention in AIG, GM, housing, and now healthcare do to preserve America's freedom?
Status 20.9: UNANSWERED
Question 20.10: Do you see any other societal inequities that you plan to correct by retribution of resources?
Status 20.10: UNANSWERED
Question 21.1: Do you believe health care is a right? If so, why? Note: if it requires someone else's time, energy, or money, then aren’t we bonding someone else for this “right”?
Status 21.1: UNANSWERED
Question 21.2: What part of your decision on this bill, if any, is affected by a consideration for liberty, individual rights, and the Constitution?
Status 21.2: UNANSWERED
Question 21.3: Would you consider opposing this bill for no other reason than because it gives more power to government at the expense of the freedom and property rights of private businesses and individuals?
Status 21.3: UNANSWERED
Question 21.4: Would you consider opposing this bill simply because it grants powers to the government that are not authorized anywhere in the Constitution?
Status 21.4: UNANSWERED
Question 21.5: Thomas Jefferson said, "A wise and frugal government which shall restrain men from injuring one another, which shall leave them otherwise free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned. This is the sum of good government." Notice what is not on his list: government-provided housing, or government-provided food, or government-provided health care. And Jefferson's views on the role of government were widely shared by America's Founding Fathers. So my question is: Please explain where you disagree with the vision of our Founding Fathers, and why.
Status 21.5: UNANSWERED
Question 21.6: Do you believe it is moral to use the force of law to mandate that every person legally residing in the USA be made purchase a specific product from a for-profit private company?
Status 21.6: UNANSWERED
Question 21.7: If you believe in the public sector competing with the private sector, why is it illegal for any entity but the Postal Services to deliver First Class Mail?
Status 21.7: UNANSWERED
Question 22.1: What constitutional grounds does the federal government have to proceed with any form of control over health care?
Status 22.1: UNANSWERED
Question 22.2: The president has accused insurance companies of discriminating against people for various reasons such as pre-existing condition. Do you believe that government should act to restructure any existing contracts other than insurance contracts? If so, what is the legal basis for doing so?
Status 22.2: UNANSWERED
This section is to ensure no questions are lost. If a question has been removed for any reason, it will be listed here with the reason it was removed.
Question 23.1: How can you refute specific questions and concerns when there is no final Bill ready for debate?
Reason for Removal 23.1: These questions are asked about a concrete healthcare bill before it is voted on. Although some of the questions can be answered in a general context, this document means to concentrate on questions related to a concrete plan (bill) and find what holes may be in it.
Question 23.2: If I am unsatisfied with my doctor or want additional opinions, how easy will it be for me to select a new doctor or get an independent, second opinion?
Reason for Removal 23.1: Duplicate Question 5.2:
Question 23.3: Will you be able to get supplemental insurance for things not covered?
Reason for Removal 23.1: Duplicate Question 5.10:
Question 23.4: A lot of people have been upset about Congress passing bills that they haven't had time to read—and they haven't even finished writing the health-care bill yet. But what I want to know is, with a bill this big and complex, have you taken the time to read it and understand it? Can you really say that anyone has had the time to figure out how all the parts will work together and what all of the consequences will be? With a bill this big, is it even possible to figure out all of that and really know what you're voting for?
Reason for Removal 23.1: Duplicate Question 6.1:
Question 23.5: If the government requires insurers to accept all customers and charge all the same price, regulates all aspects of their marketing to make sure they aren’t discriminating, and then redistributes the profits to make sure that no company gets penalized unfairly, in what sense is the industry still “private”?
Reason for Removal 23.1: Duplicate Question 11.2: